Cold Intolerance: Why You Always Feel Cold and What a Visit Can Check

What it involves

MedlinePlus defines cold intolerance as an abnormal sensitivity to a cold environment or cold temperatures, and says it can be a symptom of a problem with metabolism. It notes that some people, often thin older women, tolerate cold poorly because they have little body fat to keep them warm.

Who this is for

• Adults who feel cold when others around them are comfortable
• Patients who also notice tiredness, dry skin, constipation or weight change
• People whose fingers and toes turn pale or blue in the cold
• Anyone whose sensitivity to cold has been getting worse over months

What to expect

• Questions about whether you have always been sensitive to cold or whether it developed recently and is getting worse
• A look at your diet, weight and general health, plus a physical exam
• Blood tests that can include a blood count, a metabolic panel and thyroid hormone tests
• A plan for the cause that is found, or a referral if a specialist is the right next step

What MedlinePlus lists as causes

The MedlinePlus encyclopedia names anemia, anorexia nervosa, blood vessel problems such as Raynaud phenomenon, chronic severe illness, general poor health, a problem with the hypothalamus, the part of the brain that controls body temperature, and an underactive thyroid. It says the home care step is to follow the recommended therapy for treating the cause, which makes finding the cause the real task. A visit is how that happens, and most of the causes on the list can be checked with a conversation and a blood draw.

The thyroid connection

MedlinePlus explains that the thyroid makes hormones that control how the body uses energy, and that without enough of them many body functions slow down. An underactive thyroid, or hypothyroidism, is one of the causes it lists for cold intolerance, and Hashimoto disease is its most common cause. The thyroid care page describes how thyroid problems are followed, and the thyroid blood tests guide explains what a TSH result means.

Cold fingers and toes

If the cold is mostly in the hands and feet, and they turn white or blue and then red, the issue may be blood vessels reacting to cold rather than the whole body. MedlinePlus lists Raynaud phenomenon among the causes of cold intolerance. The Raynaud guide explains that pattern in detail. Sores on the fingertips or toes, or color changes that do not return to normal, are reasons to be seen sooner than a routine visit.

Anemia and other blood causes

Low iron or a low red blood cell count leaves less oxygen reaching the tissues, and MedlinePlus lists anemia among the causes of feeling cold. Tiredness, paleness, shortness of breath on exertion and a fast heartbeat often come with it. A blood count is part of the tests MedlinePlus lists for cold intolerance, and the anemia and low iron guide explains what a result can mean.

How the visit works

MedlinePlus says the provider takes a medical history and does a physical exam, and its questions cover the time pattern, such as whether you have always been sensitive to cold, whether it developed recently, whether it is getting worse and whether you feel cold when others do not. They also cover diet, general health, height and weight and other symptoms. The tests it lists are a complete blood count, a comprehensive metabolic panel, a serum TSH and thyroid hormone levels, all of which are blood work.

Dry skin and other clues to mention

Telling your provider about the other changes you have noticed gives the visit direction. The MedlinePlus hypothyroidism page lists fatigue, weight gain, a puffy face, trouble tolerating cold, constipation, dry skin, dry thinning hair and decreased sweating among its symptoms, and the dry skin guide describes one of them. Say these out loud even if they seem unrelated. Write down when the cold feeling began and what else changed at the same time.

Sources

• MedlinePlus: Cold intolerance (medical encyclopedia)
• MedlinePlus: Hypothyroidism (health topic)